Price transparency remains elusive despite hospitals starting to post fees | Hacker News Reader

Price transparency remains elusive despite hospitals starting to post fees

npr.org

56 pointsBlack10118 comments

The article references the MyChart Estimates feature which I would recommend, having worked closely with it in the past.

You’re getting an actual price from the hospital’s billing system directly, from an on-prem website run by the hospital and not the game of telephone or billing dept > website > scraper > 3rd party

Thanks. Is it true that it is missing basic procedures like "colonoscopy", as the article implies?

Tough to say, as each hospital sets it up on their own. https://www.asge.org/docs/default-source/coding/colonoscopy_.... There might be a number of different codes applied to the same layman term for a procedure, so using Estimates and MyChart messaging with a financial counselor is frequently the fastest way to get the real answer.

I am so happy this is happening. Though the fine for noncompliance seems laughable at $300/day.

It’s certainly not punitive but I can imagine at some point an administrator will notice a $9,000 / month expense and wonder if they should be posting prices.

The cost associated with having patients potentially switch to a cheaper hospital could be >$9000/month, at least if the data becomes more accessible. For hospitals that charge exorbitantly high rates, it might actually be worth it to pay the fine.

Add a few zeros to the daily fine if there’s less than 90% compliance at 95% of hospitals by year end.

I'd wager the thought process wasn't so much for enforced compliance, but a tax if you do not wish to be compliant.

This might help with [semi]elective procedures. But not with emergencies. For the latter the best I hope for is an ER on my insurance list.

You should read HHS’s recently issued rule on exactly that issue for some good news - though I am not exactly clear what it will mean in practice:

https://www.hhs.gov/about/news/2021/07/01/hhs-announces-rule...

Alternate link for those hitting NPR's Cookie Wall

https://text.npr.org/1012317032

(for some reason the usual trick of substituting the www with text didn't work and kept on redirecting to their cookie pop-up)

did you try to click the reader-view icon?

The Trump administration's price transparency rule seems like a good start but this article makes it seem like compliance is inconsistent and typically the bare legal minimum (rather than meeting the intentions of the law). In reality pricing should be up-front, before you visit a provider, with clarity on exactly what services are being provided, what the cost of those services will be, and what the cost is elsewhere in the area. If additional services could be necessary based on diagnosis, the highest likelihood "add ons" should also be advertised up-front similarly. When care is provided in the moment, the same should apply. The prices also need to fit some standard that is reasonably easy to interpret, unlike the mess of codes that exist today, resulting in dubious insurance claims.

I know that's a lot and I'm sure those suggestions could use some refinement - but my worry is that the increased price transparency we're getting now is not something customers can put to use in practice. That is, it may have no effect on improving competition in healthcare. Lastly, any new rules we put into place need to have real consequences attached - like fines and jail time that would serve as actual deterrents to non-compliance.

This is a start.

It should be possible to eventually get a unified clean data format and up-to-date prices with some kind of mandated networking protocol or URL or API or something. Pick or defin some kind of medical coding standard.

Then there will need to be enforcement and real penalties for those not complying.

If they can somehow get to that point, it will make a big difference.

And I believe that enforcing data standards and interoperability should be one of the primary functions of governments or other similar organizations.

Also, interested to see how this stuff intersects with the new surprise medical costs rules.

The real question is, how much does this policy cause prices to fall?

That's what Trump promised, to lower the cost of healthcare, and this was one of the key pieces.

Health economist here. I’m not convinced it will cause prices to decline at all. Under some circumstances it could cause them to rise (“insurer X gets how much? We want the same.” -insurer Y). It’s going to depend on the distribution of bargaining and market power among hospitals (which have aggregated into powerful systems) and insurers (which don’t seem to get all that much pushback about prices from the large firms they act for).

I could be wrong but I expect the effect to at best very small. More likely around zero. Worst case it raises prices.

Though I do like the policy myself bc I am interested in these prices for research purposes.

Perhaps it will help with the uninsured by giving them negotiation power and the ability to compare prices between hopsitals, as the article mentions. Insurance companies, on the other hand, won't change their premiums -- but is healthcare expensive for someone with insurance?

thanks Trump.

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